Research Article| Volume 57, ISSUE 3, P377-384, March 1965

Roentgenographic findings in acute appendicitis

      This paper is only available as a PDF. To read, Please Download here.


      Roentgenographic studies of the abdomen were available in 200 of 458 consecutive patients undergoing emergency laparotomy with the preoperative diagnosis of acute appendicitis. These roentgenograms were reviewed without prior knowledge of the clinicopathologic diagnosis. Nine roentgenographic criteria were used to detect the presence of acute appendicitis and the results obtained were later tabulated according to the status of the appendix at operation.
      The most consistently helpful roentgenographic signs of acute appendicitis were localized air-fluid levels, localized ileus, and localized increased soft tissue density in the right lower quadrant of the abdomen. Other valid roentgenographic signs were appendicolith, altered right psoas shadow, gas-filled appendix, and altered right flank stripe. This study indicates that abdominal roentgenograms in certain instances can be of value in establishing the diagnosis of this common and sometimes diagnostically troublesome disease.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Berg R.M.
        • Berg H.M.
        Radiology. 1957; 68: 839
        • Bird Jr., G.C.
        • Fissel G.E.
        • Young B.R.
        Pathognomonic roentgen sign of retroperitoneal abscess: Report of 2 cases of ruptured appendix with positive roentgen findings.
        Am. J. Roentgenol. 1948; 59: 351
        • Brady B.M.
        • Carroll D.S.
        The significance of the calcified appendiceal enterolith.
        Radiology. 1957; 68: 648
        • Buckstein J.
        The digestive tract in roentgenology.
        J. B. Lippincott Company, Philadelphia1948
        • Carras R.
        • Friedenberg M.J.
        A clinical and radiographic study of appendiceal fecalith: A review of the literature and report of seven cases.
        Ann. Surg. 1960; 151: 374
        • Chapple C.F.
        Appendiceal calculi: A report of two cases and a brief review of the literature.
        Brit. J. Surg. 1951; 38: 503
        • Clark L.P.
        Calculi in the appendix.
        Brit. J. Surg. 1952; 40: 272
        • Faegenburg D.
        Fecaliths of the appendix.
        Am. J. Roentgenol. 1963; 89: 752
        • Frimann-Dahl J.
        Roentgen examinations in acute abdominal diseases.
        Charles C Thomas, Publisher, Springfield, Ill1951
        • Greenberg B.E.
        Spontaneous pneumoperitoneum in appendicitis.
        Radiology. 1961; 77: 248
        • Laforet E.G.
        • Greenler J.J.
        • O'Brien Jr., E.J.
        Acute appendicitis with radiopaque appendiceal lithiasis.
        Am. J. Roentgenol. 1951; 65: 867
        • Laurell H.
        Rontgenologisch zeichen abdomineller Ergusse. Zugleich ein Beitrag zur Rontgendiagnostik der Peritonitis.
        Acta radiol. 1926; 5: 63
        • McCort J.
        Extra-alimentary gas in perforated appendicitis.
        Am. J. Roentgenol. 1960; 84: 1087
        • Meyerowitz B.R.
        Appendicular calculi.
        Brit. J. Radiol. 1960; 33: 631
        • Musgrove J.E.
        Unusual roentgenographic findings in gangrenous appendicitis.
        Canad. M. A. J. 1962; 67: 666
        • Pierleoni E.E.
        • Johnson L.C.
        Perforation of the vermiform appendix into the retroperitoneal space.
        Gastroenterology. 1955; 29: 308
        • Roux
        These de Doctorat, Lausanne.
        J. de Radiol. et d'electrol. 1913; 1 (Cited by Strom.22): 417
        • Samuel E.
        The gas-filled appendix.
        Brit. J. Radiol. 1957; 30: 27
        • Shanks S.C.
        • Kerley P.
        A textbook of x-ray diagnosis. W. B. Saunders Company, Philadelphia1950
        • Soteropoulos C.
        • Gilmore J.H.
        Roentgen diagnosis of acute appendicitis.
        Radiology. 1958; 71: 246
        • Steinert R.
        • Hareide I.
        • Christiansen T.
        Roentgenologic examination of acute appendicitis.
        Acta radiol. 1943; 24: 13
        • Strom S.
        On the roentgen diagnostics of changes in the appendix and caecum.
        Acta radiol. 1921–1922; 1: 133
        • Weisflog
        Zur rontgenographischen diagnose der Enterolithen des Processus Vermiformis.
        Fortschr. a. d. Geb. d. Rontgenstrahlen. 1906; 10 (Cited by Berg and Berg.1): 217